Takano Eiko, Aritake Tsukasa, Hashimoto Kakeru, Suzuki Yumi, Kitagawa Yuichi, Fujishiro Ken, Kawabata Yasuji, Kobayashi Shinichirou, Kondo Izumi
Assistive Robotics Center, National Center for Geriatrics and Gerontology, Japan.
Department of Gastroenterological Surgery, National Center for Geriatrics and Gerontology, Japan.
JAR Life. 2025 Feb 12;14:100006. doi: 10.1016/j.jarlif.2025.100006. eCollection 2025.
Postoperative changes in body composition and nutritional challenges are significant concerns for older patients undergoing gastrointestinal (GI) cancer surgery. This study compared body composition changes and nutritional outcomes between patients with upper gastrointestinal (UGI) and lower gastrointestinal (LGI) cancers over 12 months to identify tailored postoperative care needs.
This retrospective study included 55 Japanese patients (≥65 years) who underwent curative GI cancer surgery at the National Center for Geriatrics and Gerontology between 2018 and 2022. Patients were categorized as UGI ( = 17) or LGI ( = 38). Body composition parameters, including body mass index (BMI), fat-free mass (FFM), and body fat mass (BFM), were measured preoperatively and at 1, 3, 6, and 12 months postoperatively using bioelectrical impedance analysis. Two-way repeated-measures ANOVA was conducted, adjusting for age, sex, surgical method, operation time, blood loss, infection rates, and MMSE scores to minimize bias.
UGI patients showed significant reductions in weight, BMI, FFM, and BFM postoperatively, indicating a higher risk of malnutrition and muscle loss. In contrast, LGI patients exhibited stable or increasing trends in these parameters. Significant time and interaction effects were observed for FFM and BFM (p<0.05), underscoring differential recovery patterns between groups.
UGI patients face a higher risk of postoperative malnutrition and muscle loss compared to LGI patients, who showed more favorable recovery trajectories. Early, intensive nutritional interventions and personalized rehabilitation strategies are essential for mitigating muscle wasting and improving outcomes in UGI patients.
身体成分的术后变化和营养挑战是接受胃肠道（GI）癌手术的老年患者的重大关切问题。本研究比较了上消化道（UGI）癌和下消化道（LGI）癌患者在12个月内的身体成分变化和营养结局，以确定术后针对性的护理需求。
这项回顾性研究纳入了2018年至2022年期间在国立老年医学和老年学中心接受根治性GI癌手术的55名日本患者（≥65岁）。患者被分为UGI组（n = 17）或LGI组（n = 38）。使用生物电阻抗分析在术前以及术后1、3、6和12个月测量身体成分参数，包括体重指数（BMI）、去脂体重（FFM）和体脂肪量（BFM）。进行双向重复测量方差分析，并对年龄、性别、手术方法、手术时间、失血量、感染率和简易精神状态检查表（MMSE）评分进行调整，以尽量减少偏差。
UGI患者术后体重、BMI、FFM和BFM显著降低，表明营养不良和肌肉流失风险更高。相比之下，LGI患者在这些参数上呈现稳定或上升趋势。观察到FFM和BFM存在显著的时间和交互效应（p<0.05），突出了两组之间不同的恢复模式。
与LGI患者相比，UGI患者术后营养不良和肌肉流失的风险更高，LGI患者的恢复轨迹更有利。早期、强化的营养干预和个性化的康复策略对于减轻UGI患者的肌肉消耗和改善结局至关重要。
